Monthly Archives: September 2015

On September 28, 2015, Lambda Legal launched the newest section of its Know Your Rights information hub. “Know Your Rights: HIV” provides information for people living with HIV people on topics such as disclosure and discrimination in housing, healthcare and employment.

“Based on calls to our Legal Help Desk, people living with HIV still face, even in 2015, continued discrimination rooted in ignorance, unfounded fear, misconceptions and outdated science,” said Scott Schoettes, Senior Attorney and HIV Project National Director.

“When denied access to health care or fired from a job because they have HIV, people living with HIV will be able to turn to the “Know Your Rights: HIV” hub to provide much-needed information to help access and navigate the resources and protections that are available. This resource helps to further educate the public and end the stigma and discrimination that people with HIV encounter. Such stigma and discrimination hinder efforts to combat the epidemic.”

Launched the day after the 2015 National Gay Men’s HIV/AIDS Awareness Day, the “Know Your Rights: HIV” hub provides a wide range of information about the rights of all people living with HIV, regardless of sexual orientation or gender identity.

“Though Lambda Legal is primarily an LGBT organization, our mission with respect to HIV covers all people living with HIV, regardless of sexual orientation or gender identity,” said Kyle Palazzolo, HIV Project Staff Attorney. “We believe everyone living with HIV will find this information useful, and we hope that even more people will call our Legal Help Desk when seeking guidance.”

Test-and-treat’ is unlikely to be an effective strategy to control the HIV epidemic in the United States without improvements in retention in care, investigators argue in the online edition of Clinical Infectious Diseases. A mathematical model suggested that without interventions to address poor levels of engagement in HIV care, there could be as many as 1.39 million new HIV infections in the US over the next 20 years, at a cost of $256 billion. Targeting testing and linkage would only prevent 21% of these new infections. But a package of interventions comprising testing, linkage and retention in care would prevent over half of the projected new infections, reduce AIDS-related mortality by almost two-thirds and be cost effective.

“To alter the course of the HIV epidemic in the United States, strategies of ‘test and treat’ alone may be insufficient; attention to the full continuum of care will be essential,” comment the authors.

United States guidelines recommend expanded HIV testing and antiretroviral therapy at any CD4 count as strategies to reduce rates of AIDS-related deaths and HIV transmissions. However, this approach may not be as effective as hoped. Recent research has shown that there is significant attrition at each stage of the HIV care continuum in the US. Up to a fifth of HIV-infected individuals are undiagnosed; 20% of recently diagnosed patients are not linked to care within 90 days; 54% of patients are not retained in care; only 30% of diagnosed patients have an undetectable viral load.

Diagnoses of gonorrhea among men who have sex with men are apparently rising in the United States. Centers for Disease Control and Prevention (CDC) researchers, in order to determine demographic information, interviewed a random sample of individuals diagnosed with the sexually transmitted infection (STI) in 12 areas across the country between 2010 and 2013. The researchers then used census and Gallup opinion polling data to estimate the respective sizes of the U.S. MSM, heterosexual male, and female populations by age group at the state, county and city levels.

In 2010, there were an estimated 1,169.7 diagnoses of gonorrhea per 100,000 MSM. In other words, about 1.17 percent of MSM contracted the STI that year. This rate rose 26 percent in three years, hitting 1,474.4 diagnoses per 100,000 MSM, or 1.47 percent, in 2013. Looking at MSM according to age bracket, those between 25 and 29 years of age had the highest diagnosis rate: 3,400 per 100,000, or 3.4 percent.

During the study period, gonorrhea diagnosis rate among MSM was between 10.7 and 13.9 times higher than that of women or heterosexual men. While the researchers speculate that the rising gonorrhea rates may be indicative of a national trend, they caution that the data in this study is not nationally representative.

There’s a lot of misinformation circulating around the internet and in conversations about PrEP (Pre-exposure prophylaxis), the single-daily dose of Truvada, once only used to treat those living with HIV, but now available and approved by the FDA to prevent new HIV infections in negative individuals. PrEP has proved to be more than 90 percent effective in clinical trials when taken as prescribed along with condom use. That’s great. But paying for PrEP, whether you’re insured or not, can be a stressful and expensive experience.Georgia Voice is here to provide you with some basic information about how you can get access to and pay for PrEP. This is by no means a comprehensive list. And of course, you’ll want to consult your health care provider before beginning any drug regimen.

The uptake of PrEP in people who need it risks being limited due to low levels of awareness, gaps in health insurance, opaque bureaucratic procedures, under-usage of medical services, and limited awareness and skills in healthcare providers, according to an analysis published online ahead of print in Clinical Infectious Diseases. Also taking into account sub-optimal adherence among some PrEP users, the researchers conclude that just 15% of gay men in the American city of Atlanta who could benefit are likely to achieve protection from HIV with PrEP.

The PrEP care cascade

Colleen Kelley and colleagues at Emory University outline a ‘care cascade’ or ‘continuum of care’ for PrEP which identifies the key steps in the process of getting hold of PrEP and using it effectively. Analysis of the care cascade can help focus attention on where there are significant barriers to a person moving on to the next step.

After two and a half years of trials, a new study has found no new HIV infections among a group of people on pre-exposure prophylaxis (PrEP). For 32 months, researchers at the Kaiser Permanente Medical Center in San Francisco tracked the health of over 600 people as they used Truvada daily to prevent the virus in a real-world setting.

The average age of the study participants was 37, and 99 percent were men who have sex with men. The average length of individual usage was 7.2 months. Members of this group also reported a higher likelihood of having multiple sex partners than those not using PrEP. No one in the study contracted HIV.

Lead author Jonathan Volk, a physician at Kaiser Permanente San Francisco, emphasized that this is the first time such a study has been done in a clinical practice setting at this size. The findings were published Wednesday in Clinical Infectious Diseases, a leading journal of studies on infection disease.

The medical staff at the Pitt Men’s Study emphasize that PrEP is not a substitute for condoms. It should be used in addition to condoms, to further reduce your risk. It is also important to note that PrEP doesn’t protect against other STDs like syphilis, chlamydia, and gonorrhea. To learn more about PrEP, check out the CDC’s Website. If you have questions about PrEP, you can speak to your doctor. You can also call the PrEP clinic at the University of Pittsburgh Medical Center: (412) 647-0996.

In the early years of the epidemic, there were few who thought that we would ever focus on HIV and aging. In fact, many providers are still not facing the massive change in the age of people with HIV and the challenges that come with it.

Although we are seeing new HIV infections in people over 50, the main reason for the rising number of older adults with HIV is better HIV medications. In 1985, a 20-year-old with AIDS might expect to live only to age 22. Today, that 20-year-old can look forward to an almost normal lifespan. This year, half of those living with HIV in the U.S. will be over 50. By 2020, that number may rise to 70%.

But HIV is not the only health issue these older adults face. Research shows that people with HIV have an increased risk of many illnesses associated with aging. These conditions, including heart disease, cancers, kidney disease, osteoporosis, and others, are occurring more often and sometimes earlier than expected. Also, mental health conditions like depression are common among those with HIV.